Center for Life Resources Needs Assessment for Community Members
If you live in one of the counties where we provide services, please continue.
*
1.
In what county do you currently live?
(Required.)
Brown
Coleman
Comanche
Eastland
Gillespie
Kendal
Kerr
Kimble
Mason
McCulloch
Menard
Mills
San Saba
2.
What is your age?
Under 18
18-24
25-34
35-44
45-54
55-64
65+
3.
What is your birth gender?
Female
Male
4.
What is the highest level of school that you completed or highest degree received?
No schooling completed
Grade K-4
Grade 5-8
Grade 9-12 no diploma
High School Diploma
GED
Trade school
Associate's degree
Bachelor's Degree
Master's Degree
Doctorate's Degree
5.
If you are age 16 and over, what is your current employment situation?
Self-Employed
Employed Full-time
Employed Part-time
Stay at home spouse/parent
Full time student
Disabled and not able to work
Retired
6.
Are you presently or have you been in the US Armed Forces?
Yes
No, skip to question 9
7.
Select your current status.
Active
Reserve
National Guard
Honorable Discharge
Discharge or release under conditions other than dishonorable
Dishonorable Discharge
8.
In which branch of the US Armed Forces did or are you servicing?
Army
Marine Corp
Navy
Airforce
Space Force
Coast Guard
9.
Where would you go if you were needing help with a mental health issue?
Center for Life Resources
Private Counselor
Primary Care Provider
Pastor/Clergy
Friend
family
Emergency Room
Other (please specify)
10.
Which mental health services are needed in your county? Select all the apply
Autism Services
Early Childhood Intervention Services (case management, PT/OT/SLT)
Case Management/Service Coordination
Skills Training/psychosocial rehab
Counseling
Outpatient Substance Use Treatment
Inpatient Substance Use Treatment
Crisis Services
Crisis Respite Services
ICF
Texas Home Living or HCS services
Psychiatric Medications and Monitoring
Supported Employment
Supported Housing
Family Partner/Peer Services
Veterans Services
Inpatient Psychiatric Hospitalization
Other (please specify)
11.
If you need mental health service which way would you MOST often want to receive these services?
Face to Face in person
Video appointment
Phone appointment ( audio only no video)
12.
Please identify the main 3 barriers that you or people in your county experience when seeking or receiving help with mental health services.
Don't have transportation.
Don't know where to go
Service not offered outside of 8-5 Monday thru Friday
Don't have insurance or a way to pay
Don't know how to use technology for virtual visits
My internet service is too slow for virtual visits
System is too difficult to navigate
Religious reasons
Cultural reasons
Waiting list for services
Other (please specify)
13.
Please select the top 3 needs of yours or people in your county.
Transportation
Affordable Housing
Affordable Internet Service
Money Management and financial planning
Employment
Counseling
Primary Care Providers
Assistance in applying for health insurance
Assistance in paying for medication
Training for suicide prevention
Assistance with utilities
Assistance in eating healthy
14.
Are there other needs that people experience in your county? Please describe.
15.
Which language do prefer to speak and for services to be provided?
English
Spanish
German
Korean
French
Vietnamese
Chinese
Tagalog
Hindu
Arabic
Russian//Polish/ or other Slavic language
Other Indo-European language
Other Asian and Pacific Island language
Other (please specify)
16.
Do you know what this number is 800-458-7788?
No idea
Yes, Center for Life Resources 24/7 crisis hotline number
17.
If you wish to be in a drawing for a backpack style cooler, please leave your full name and a working phone number so that if you are randomly selected we can contact you when our survey closes in March of 2025.
